Sciatica can be a horrible condition that causes pain, tingling and numbness from the lower back, down the leg and into the foot. It can be debilitating and often stop you being able to perform daily tasks. In this article, I'll explain what it is, the main causes and what you can do if you have some sciatica symptoms coming on to ease them before they get too worse.
After suffering a back injury in the gym years ago, I quite literally feel your pain. So hopefully the information below can help you understand and manage any sciatica-related pain you might have.
What is sciatica?
Sciatica is a condition that causes pain, weakness, numbness, or tingling in the leg, and is caused by injury to or pressure on the sciatic nerve. The sciatic nerve branches from the lower back through the hips and buttocks and down each leg. Sciatica pain can be almost anywhere along the nerve pathway, and it's especially likely to follow a path from the low back to the buttock and the back of a thigh and calf. The pain can vary from a mild ache to a sharp, burning pain, and sometimes it can feel like a jolt or electric shock.
Sciatica happens when irritation, inflammation, pinching, or compression affect one or more nerves that run down your lower back and into your legs. The most common causes of sciatica are age-related changes in the spine, such as herniated disks and bone spurs, obesity, a job that requires twisting the back, carrying heavy loads, or driving a motor vehicle for long periods, and prolonged sitting.
Although the pain associated with sciatica can be severe, most cases clear up with treatment in a few weeks. Self-care treatments such as rest, ice or heat, and over-the-counter pain medications can help relieve the pain. However, severe cases may need surgery.
Sciatica risk factors
There are some things that naturally put you at higher risk of suffering from sciatica symptoms. It cannot always be prevented, but understanding some common causes can help reduce your risk of suffering from it. The following are some of the risk factors for developing sciatica:
Non-modifiable risk factors:
- Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.
- Genetics: Some people may be more prone to developing sciatica due to their genetic makeup.
Modifiable risk factors:
- Obesity: carrying extra weight changes the mechanics of your spine, making nerve compression more likely.
- Poor posture: An exaggerated curve in your lower back, hunched shoulders, a flat back, or a tipped pelvis can all cause tension in your back and leg muscles, which can easily pinch your sciatic nerve.
- Physically demanding work: Repetitive motions that involve lifting heavy objects daily can put too much pressure on your spine and irritate the sciatic nerve.
- Smoking: Smokers are more likely to experience sciatica because nicotine can cause inflammation and damage to the nerves.
- Physical inactivity: Sitting for long periods and a lack of physical activity can contribute to an increased risk of sciatica.
It's important to note that having one or more of these risk factors does not necessarily mean that you will develop sciatica. However, being aware of these risk factors and taking steps to modify the modifiable ones can help reduce your risk of developing sciatica.
What to do if you get sciatica?
If you experience sciatica, there are several things you can do to help relieve the pain and discomfort. Here are some steps you can take:
- Rest: Although resting for a day or so may provide relief, staying inactive will make symptoms worse.
- Apply cold or heat: Cold or ice packs can help reduce pain and swelling during the first few days after sciatica pain starts. You can use an ice pack or a bag of frozen peas wrapped in a clean towel. After a few days, switch to heat. Apply a warm towel or heating pad to the affected area.
- Take over-the-counter pain relief: Anti-inflammatories such as ibuprofen and naproxen are sometimes recommended for sciatica. Use only as directed. I personally recommend the Ibuleve Max gel for almost instant pain relief of a lot of musculoskeletal issues. However it is important to check with a pharmacist that you are ok to use it.
- Try alternative therapies: Alternative therapies often used for low back pain include acupuncture and chiropractic.
- Stay active: Although it may be tempting to rest, staying in motion will reduce inflammation and help relieve the pain.
- Physical therapy: Once the pain improves, a healthcare provider can design a program to help prevent future injuries. Physical therapy can help improve your posture to take pressure off the sciatic nerve and develop a stretching and exercise routine for you.
- Surgery: Although most commonly not required, surgery may be the best option when sciatica is more severe. Usually, healthcare providers don’t recommend surgery unless you have symptoms that indicate nerve damage is happening or imminent. They may also recommend surgery if your symptoms don’t improve after six to eight weeks of conservative treatment.
It's important to note that most cases of sciatica clear up with treatment in a few weeks. However, if you experience severe pain or symptoms that don't improve with self-care measures, it's important to seek medical attention.
Exercises to help relieve sciatica pain
Sciatica pain can be debilitating, but there are several exercises that can help relieve the pain and increase your range of movement to make daily activities and moving around easier while you recover. Here are some exercises that you can try at home:
Knee-to-chest exercise
This simple stretch targets the lower buttock and upper thigh area.
- Lie on your back with your legs bent and your feet flat on the floor.
- Bring one knee to the chest while keeping the other foot on the floor.
- Keeping the lower back pressed to the floor, hold for up to 30 seconds.
- Repeat with the other leg.
Pelvic tilt exercise
This is another deceptively simple exercise that is good for sciatica.
- Lie on your back with your legs bent and arms by your side.
- Tighten your abdominal muscles and tilt your pelvis towards your heels.
- Hold for 5 seconds and release.
- Repeat 10 times.
Glute bridge exercise
This exercise strengthens the glutes and lower back muscles.
- Lie on your back with your knees bent and feet flat on the floor.
- Tighten your core and lift your hips off the ground until your body forms a straight line from your shoulders to your knees.
- Hold for 5 seconds and release.
- Repeat 10 times.
Seated glute stretch
This stretch targets the glutes and piriformis muscles, which can become inflamed and press against the sciatic nerve.
- Sit on the floor or a chair with your legs out in front of you.
- Bend your right leg, putting your right ankle on top of the left knee.
- Lean forward and allow your upper body to reach toward your thigh.
- Hold for 15-30 seconds and release.
- Repeat with the other leg.
It's important to note that stretching exercises can help manage sciatica, but you should work with a qualified healthcare professional to ensure you know how to do the exercises safely. In addition, if you experience severe pain or symptoms that don't improve with self-care measures, it's important to seek medical attention.
Some Frequently Asked Questions about Sciatica:
Can sciatica be cured?
This is very dependant on the cause of your sciatica. The majority of sciatica symptoms are relieved within a few days, once the inflammation that is putting pressure on your nerve reduces. For more severe cases such as when people have been in a serious road traffic accident, sciatica can be a chronic issue as a consequence of other injuries.
To know more accurately how long your sciatic nerve pain could last, you should be assessed by a medical professional.
Can sciatica cause knee pain?
The term "sciatica" refers to the pain itself really, rather than an "injury" so knee pain can be part of your sciatica but could be caused by something further up the chain. For example if you have a bulging spinal disc putting pressure on the nerve, it is possible for the symptoms and pain to travel down the leg into the knee. However, equally if you gave a knee injury which is aggravating a nerve, it can present as sciatica like symptoms.
Can sciatica cause hip pain?
Similarly to knee pain, hip pain and sciatica can be closely linked. Due to the large range of movement available at the hip, there are several muscles, tendons, ligaments etc that surround the joint and inflammation of any of them can aggravate the nerve which passes through it. Conditions such as osteoarthritis of the hip, piriformis syndrome and hip bursitis can also present as sciatica and cause that common shooting/electric type pain through the hip and down into the leg.
Is sciatica dangerous?
Sciatica itself isn't necessarily dangerous, but it can be a secondary symptom of a more serious injury or illness. It is more commonly a short term symptom as a result of a muscular strain, however can be a symptom of a more serious pathology such as a disc injury or even illnesses such as cancer. If your pain is severe, you are struggling to sleep and/or you have been suffering from sciatica for a while, you should visit your doctor to get checked out.
When to see a doctor about sciatica?
If you are ever concerned that your symptoms might be the result of something serious, you should visit your doctor for an assessment. As explained above, it is commonly not serious however can be a symptoms of some nasty injuries and illnesses. If you are unsure, visit your doctor as soon as possible. Some red flags would require an immediate assessment. Red flags are warning signs that indicate a more serious underlying condition and require immediate medical attention. Here are some red flags of sciatica:
1. Pain that is sudden, severe, or intolerable, especially if it is accompanied by numbness or muscular weakness in a leg.
2. Bowel or bladder problems, such as incontinence or retention.
3. Loss of sensation in your legs and/or feet.
4. Progressive neurological weakness.
5. Swelling in any part of the body.
6. Severe back pain.
7. Saddle anaesthesia.
8. Sexual dysfunction.
9. Fever.
10. Unexplained weight loss.
It's important to note that relying solely on self-treatment or ignoring the symptoms of sciatica can worsen your condition. If you experience any of these red flags, it's important to seek medical attention immediately. While sciatica can often be treated with non-invasive measures, it's important to watch for red flags that may indicate a more serious underlying condition.
